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General NPI Number Information
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NPI Number | 1154316628
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Entity Type | Organization
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Legal Business Name | ST LUKES CATARACT & LASER INSTITUTE
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Dates
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Enumeration Date | 09/12/2005
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 43309 US HIGHWAY 19 N
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City | TARPON SPRINGS
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State | FL
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Zip | 34689-6221
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Country | US
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Telephone | 727-943-3111
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Fax | 727-943-3334
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Provider Business Mailing Address
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Address Line | 43309 US HIGHWAY 19 N
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City | TARPON SPRINGS
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State | FL
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Zip | 34689-6221
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Country | US
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Telephone | 727-943-3111
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Fax | 727-943-3334
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | MARK H LINDBERG
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Credential |
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Telephone | 727-943-3111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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